Infection Prevention Update Marie Kassai, RN, BSN, MPH, CIC, FAPIC

Objectives Upon completion, the participants will be able to: State the new CMS and APIC Infection Prevention Issues Surgical Attire Housekeeping Reconstituting medications for OR Initiate HIV Testing on Source Patient State the issues related to Legionella

Surgical Attire APIC and CMS emphasized complete covering of hair and ears ACS – 10/2016 Skull cap can be worn “when close to the totality of hair is covered by it and only a limited amount of hair on the nape of the neck or a modest sideburn remains. Survey Procedures - 485.639 That operating room attire is suitable for the kind of surgical case performed, must wear only clean surgical attire, that surgical attire is designed for maximum skin and hair coverage

Surgical Attire The following agencies have adopted the requirement for full head covering: CDC – HICPAC Guidelines - 1999 OSHA – Blood Borne Pathogens - 2001 WHO – Guidelines for Safe Surgery – 2009 AST – Association of Surgical technologists – 2007 AORN – 2015 – Guidelines for Perioperative Practice Current recommendation – Wear surgical attire for procedures, such as endoscopy and pain management.

Legionella ASC need to be aware of the issue per CMS No requirements to do water survey Know the possible sources of legionella Water fountains Ice Machines Water Heaters Water Storage Tanks Eyewash Stations Hot Tubs Decorative Fountains This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY

ANSI Requirements for Eye Wash Stations Read the document carefully to evaluated where the eye wash is needed. Need MIXER Valves in order to maintain water from 60 to 100 degrees Device must be tested weekly and documented Temperature must also be documented.

HIV Testing SOURCE PATIENT MAY NOW BE TESTED FOR HIV POST STAFF EXPOSURE This Photo by Unknown Author is licensed under CC BY-SA

Housekeeping Products Used – Who checks? Who Trains the Housekeepers ? Competency – Who ensures Competency ? Things to check Mixing of solution Labeling of bottles Utilization of mops and water Annual Training – who does it ? This Photo by Unknown Author is licensed under CC BY-NC-ND

Endoscopy Wear surgical attire Document end of case until the beginning of cleaning Scan scope with magnifying light prior to processing Check cleaning with Channel Check or other product – Risk Assessment Transport in plastic container which is marked, cleaned and marked again

NEW Information Two Dose Hepatitis B Vaccine – Heplisav-B Flu Vaccine – Plan for vaccinations – Most using Quad New Information – Measles – Now reports of fatal consequences Sterile Cystoscope – with Endosheath – Follow IFU for use and cleaning New Respiratory Device - CircuitGuard - States it is disposable – question is when and after how many patients